Contrast Observation Of The Efficacy Of Discogenic Low Back Pain Treatment Using Coblation Nucleplasty Combined With Ozone

ObjectiveTo compare the curative effect of discogenic low back pain with percutaneous coblation nucleplasty and percutaneous coblation nucleplasty combined with ozone under C-arm guidance, and to evaluate the clinical effect of percutaneous coblation nucleplasty combined with ozone for discogenic low back pain.Methods85cases of contained discogenic low back pain, which were diagnosed by physical examination, CT scanning and/or MR imaging from August2008to April2011at the department pain of second hospital of TianJin Medical University. They were randomly divided into two groups, with43patients in group A and42patients in group B. The technique of percutaneous coblation nucleplasty was applied in group A, and the percutaneous coblation nucleplasty combined with ozone applied in group B. Group A includes28males and15females. The average of age was53.8years old, ranging from24to75. Single level was treated in40patients,2-level in3. Group B includes25males and17females. The average of age was55.2years old, ranging from25to74Single level was treated in36patients,2-level in6. There were no significant statistical difference (P>0.05). The VAS and JOA scores were recorded at different time of followed-up, including before operation,2w,1m,3m,6m,12m after operation. The improved Macnab criterion was adopted to evaluate the clinical effect.ResultsThe therapy was performed successfully in all cases.84patients were followed up in all patients. In group A,1case had no obvious efficacy, and discitis occurred in one case, endplate inflammation occurred in one case, one case occurred symptom increased. In B group,2case occurred symptom increased, no other serious complication occurred. All patients in two groups were followed up for12-42months, with28.4±10.6moths. The VAS score in group A before operation,2w,1m,3m,6m,12m after operation were12±2.31,2.88±1.42,2.41±1.18,2.20±1.11,1.98±0.95and2.13±1.04, respectively. And those in group B were7.13±2.33,2.23±1.40,1.90±1.14,1.71±1.08,1.55±0.90and1.68±1.02, respectively. There was significant different between before and after operation (P<0.01), and there was significant different between two groups after operation (P<0.05). The JOA score in group A before operation,2w,1m,3m,6m,12m after operation were6.63±2.85,20.21±2.73,22.67±2.85,23.21±2.74,23.63±2.65and23.80±2.55, respectively. And those in group B were6.57±2.7,22.13±2.98,24.11±2.76,24.98±2.64,25.37±2.45and25.53±2.32, respectively. There was significant different between two groups after operation (P<0.05). According to the modified Macnab criterion, the effective rate in A group2w,1m,3m,6m,12m after operation were78.57%,80.95%,83.33%,85.71%and85.71%, respectively. And those in Group B were90.48%,92.86%,95.24%,95.24%and95.24%, respectively.ConclusionThe efficacies of the technique of percutaneous coblation nucleplasty combined with ozone to treat discogenic low back pain have more advantage than the technique of percutaneous coblation nucleplasty alone. Percutaneous collation nucleoplasty is better method for the treatment of discogenic low back pain because it has several advantages of minimal invasion, shorter time for recovery, Assured curative effects and safer. It is an effective, safe treatment for discogenic low back pain, but surgical indications must be strict mastered.